Drug titration

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Therapeutic (green) and side effect dose response curves (red) illustrating a typical starting and progressively increasing titrated doses (arrows). Titrated doses.svg
Therapeutic (green) and side effect dose response curves (red) illustrating a typical starting and progressively increasing titrated doses (arrows).

Drug titration is the process of adjusting the dose of a medication for the maximum benefit without adverse effects. [1]

When a drug has a narrow therapeutic index, titration is especially important, because the range between the dose at which a drug is effective and the dose at which side effects occur is small. [2] Some examples of the types of drugs commonly requiring titration include insulin, anticonvulsants, blood thinners, anti-depressants, and sedatives. [3] [4] [5]

Titrating off of a medication instead of stopping abruptly is recommended in some situations. Glucocorticoids should be tapered after extended use to avoid adrenal insufficiency. [6]

Drug titration is also used in phase I of clinical trials. The experimental drug is given in increasing dosages until side effects become intolerable. [7] A clinical trial in which a suitable dose is found is called a dose-ranging study .

See also

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References

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  3. Roden DM (2014). "Chapter 5 : Principles of Clinical Pharmacology". In Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J (eds.). Principles of Clinical Pharmacology (19th ed.). New York, NY: McGraw-Hill. ISBN   978-0-07-180215-4.
  4. Olson KR, Anderson IB, Benowitz NL, Blanc PD, Clark RF, Kearney TE, Kim-Katz SY, Wu AH, eds. (11 December 2017). "Section III: Therapeutic Drugs and Antidotes". Poisoning & Drug Overdose (7th ed.). New York, NY: McGraw-Hill. ISBN   978-0-07-183979-2.
  5. Kruidering-Hall M, Campbell L (30 November 2017). "Chapter 27: Skeletal Muscle Relaxants". In Katzung BG (ed.). Basic & Clinical Pharmacology (14th ed.). New York, NY: McGraw-Hill. ISBN   978-1-259-64115-2.
  6. Furst DE, Saag KG. "Glucocorticoid withdrawal". In Matteson EL, Curtis MR (eds.). Treatment Issues in Rheumatology. Retrieved 13 June 2018.{{cite book}}: |website= ignored (help)
  7. "Dose-Response Information to Support Drug Registration" (PDF). Guideline for Industry. FDA. November 1994. Retrieved 13 June 2018.